Full Body Surface Coverage with Water-Equivalent Bolus as Novel Technique for Total Body Irradiation before Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoid Leukemia
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Data of the Treated Patients | Patient-1 | Patient-2 | Patient-3 | Patient-4 | Patient-5 |
---|---|---|---|---|---|
Indication | pre-B ALL 2nd relapse, ETV6-RUNX1 (t12;21), CNS 1 | T-ALL HR, STIL-TAL1 fusion, CNS 3 | B-ALL early relapse, chr 21 tetrasomy, RUNX1 signal overexpression, CNS 1 | CML with 2 ALL blastic phase, bcr/abl positive, CNS 1 | pre-B-cell ALL relapse bcr/abl positive, CNS 1 |
Last previous treatment | ALL-IC REL 2016-HR + blinatumomab | ALL-IC BFM 2009 | ALL-IC REL 2016 + blinatumomab | ALL-IC REL 2016 + dasatinib, blinatumomab | ALL-IC REL 2016 + dasatinib |
Number of administered CD34 positive (cells /kg) | 9.2 × 106 | 0.8 × 106 | 3.64 × 106 | 8 × 106 | 5 × 106 |
Donor type (HLA) | Matched unrelated donor (9/10) | Matched family donor (10/10) | Matched unrelated donor (12/12) | Matched unrelated donor (11/12) | Matched unrelated donor (10/12) |
Height of pts (cm) | 134 | 178 | 108 | 131 | 158 |
Body weight of pts (kg) | 36.4 | 67 | 24 | 27.7 | 53 |
Age at transplant of pts (yrs) | 10.02 | 16.52 | 5.45 | 8.75 | 17.39 |
Gender | Female | Male | Male | Male | Male |
GVHD prophylaxis | CSA, MTX | CSA, MTX | CSA, MTX | CSA, MTX | CSA, MTX |
Time to neutrophil engraftment | Day + 19 | Day + 18 | Day + 27 | Day + 23 | Day + 21 |
Adverse events | Perianal abscess (Gr3), mucositis (Gr3) sepsis (Gr3) | Mucositis (Gr3), sepsis (Gr2) | Mucositis (Gr2), sepsis (Gr2), Adenovirus viraemia | Secondary graft failure *, Adenovirus and CMV viraemia | Seizure (Gr3), mucositis (Gr4), bowel acute GVHD (Gr4), BKV and Adenovirus related (Gr2) haemorrhagic cystitis and viremia |
Conditioning regimen | ALL PED SCT Forum (TBI, etoposide) | ALL PED SCT Forum (TBI, etoposide) | ALL PED SCT Forum (TBI, etoposide) | ALL PED SCT Forum (TBI, etoposide) | ALL PED SCT Forum (TBI, etoposide) |
Follow-up time (yrs) | 2.11 | 0.69 | 1.46 | 1.43 | 0.43 |
Data of the Radiotherapy Plans | |||||
---|---|---|---|---|---|
Time min (min) | 43 | 49 | 39 | 39 | 51 |
Time max (min) | 125 | 58 | 49 | 44 | 61 |
Time avg (min) | 60.16 | 53.17 | 43 | 40.33 | 53.66 |
CBCT numbers | 18 | 18 | 18 | 18 | 18 |
Kidneys mean dose (Gy) | 9.034 | 8.256 | 8.321 | 8.232 | 8.726 |
Lungs mean dose (Gy) | 8.851 | 9.42 | 8.726 | 8.537 | 9.215 |
Iso centers | 9 | 13 | 9 | 10 | 12 |
Technic | VMAT | VMAT | VMAT | VMAT | VMAT/IMRT |
Arcs/Fields | 18 | 24 | 18 | 20 | 14 Field IMRT + 19 |
Sum MU | 2655.4 | 4987.1 | 4449 | 4094.5 | 6483.8 |
Energy | 6x photon | 6x photon | 6x photon | 6x photon | 6x photon |
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Furka, A.; Nagy, Z.; Szabó, I.; Fekete, G.; Kelemen, Á.; Bolobás, G.; Sebők, G.; Molnár, T.; Árvai, J.; Tornyi, I.; et al. Full Body Surface Coverage with Water-Equivalent Bolus as Novel Technique for Total Body Irradiation before Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoid Leukemia. Children 2022, 9, 1740. https://doi.org/10.3390/children9111740
Furka A, Nagy Z, Szabó I, Fekete G, Kelemen Á, Bolobás G, Sebők G, Molnár T, Árvai J, Tornyi I, et al. Full Body Surface Coverage with Water-Equivalent Bolus as Novel Technique for Total Body Irradiation before Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoid Leukemia. Children. 2022; 9(11):1740. https://doi.org/10.3390/children9111740
Chicago/Turabian StyleFurka, Andrea, Zsofia Nagy, Imre Szabó, Gábor Fekete, Ágnes Kelemen, Gábor Bolobás, Gábriel Sebők, Tünde Molnár, János Árvai, Ilona Tornyi, and et al. 2022. "Full Body Surface Coverage with Water-Equivalent Bolus as Novel Technique for Total Body Irradiation before Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoid Leukemia" Children 9, no. 11: 1740. https://doi.org/10.3390/children9111740